Wilms Tumor-1, Claudin-1 and Ezrin Are Useful Immunohistochemical Markers That Help to Distinguish Schwannoma from Fibroblastic Meningioma

The aim of this study is to identify immunohistochemical (IHC) markers that can reliably separate schwannoma (SCHW) and fibroblastic meningioma (FM). We selected 106 cases of intracranial SCHW (n=56) and FM (n=50) and constructed a tissue microarray (TMA) of core diameter of 1.0 mm from archival formalin-fixed paraffin-embedded tissue. ATMA-IHC was performed using 14 antibodies. After IHC staining, 98 cores were found suitable for evaluation. The IHC staining was scored as 0-2+ (0, negative; 1+, weak and/or focal 2+ strong and/or diffuse positive). A discriminant analysis (DA) (Wilks'Lambda test) was performed to assess the relative importance of these biomarkers in classifying the two groups FM and SCHW. It showed that WT-1 (Wilks'lambda 0.085, p<0.001), EMA (Wilks'lambda 0.253, p<0.001), S100 (Wilks'lambda 0.487, p<0.001), Claudin-1 (Wilks' lambda 0.57, p<0.001) and Ezrin (Wilks'lambda 0.656, p<0.001), SPARC (Wilks'lambda 0.751, p<0.01), NP-Y (Wilks'lambda, 0.819, p<0.001) and EGFR (Wilks'lambda 0.845, p=0.026) were some of the statistically significant markers that discriminated SCHW and FM. For sensitivity and specificity for SCHW the significant markers [Area under the curve (95% CI), p-value] by ROC analysis were WT-1 [ 0.990(0.000, 1.000), <0.001], S100 [0.880(0.808, 0.951), <0.001] while for diagnosing FM the most sensitive and specific markers were EMA [0.957(0.914, 1.000), <.001], Claudin-1 [0.857(0.782, 0.932), <0.001] and ezrin [0.792(0.700,0.884),<0.001]. WT-1, Claudin-1 and Ezrin may be potentially useful immunohistochemical adjuncts to EMA and S100 that differentiate SCHW from FM